Dealing with Delusions

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MINDY KIM-MILLER, MD, PhD
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Question:

My mother has Alzheimer’s. I am one of 5 kids. She thinks I am a friend from when she was 6years old. I have twins that are ten years old she does not believe that I am her daughter or they are her grand kids. She remembers the other kids. She does not want me to come over. My father just passed away 2 months ago. This all started a week after he died. My question is do I correct her, or do I let it go? It is very hard on all of us. She will tell me point I have my own parents. And she is not my kids Grandma. Are we doing her harm my telling her the truth or do we just let it go. It is very hard I feel like I am two people when I am with her.

–A.F.A.

Answer:

Dear AFA,

Delusions such as the one that your mother has about you are very common in Alzheimer’s disease. As in your case, the death of a spouse can often increase confusion and hasten loss of functioning. So it is not surprising that her confusion about you started shortly after your father’s death.

Because delusions are such firmly held beliefs that seem real to the person having them, it is usually futile to try to correct or argue about them. In fact, trying to correct the person can lead to frustration and distress, which can lead to agitation. So if you gently remind your mother about who you are, and she persists with her delusion, it is usually best to move on unless the delusion is harmful to her or others. You can either play along with her delusion or ask about her childhood friend if it is comforting to her. Perhaps she misses her and wants to talk about her. Or you can try to redirect her attention onto other, more pleasant topics.

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Some strategies you can also include modifying things that might be triggering this delusion. Perhaps something about you reminds her of her childhood friend. You can try wearing a different hairstyle, clothes, or makeup that might help distinguish you from her childhood friend. Try to remove things in her room that may be causing distress or confusion, such as mirrors, clutter, or too much noise. Have things in her room that can provide clues as to the time and place, such as a clock and calendar with the year on it. Having bright lighting and windows in the room can also help reduce confusion. If there are any objects in the room that might remind her of her own childhood, it may help to remove them. Instead, try placing familiar objects that can remind her of being a mother to you, such as family photos from your childhood or things you may have made for her or given to her.

You can also use familiar music and familiar smells that might remind your mother of who you are. Sometimes music and fragrances can trigger stronger memories than pictures or words can. So playing music that you and she enjoyed together or shared with special meaning might help her to remember you. If you and she enjoyed baking together, the smell of fresh baked goods might trigger strong memories. Wearing a perfume that you often wore around her or might have given her as a gift might also help trigger her memory. Lastly, it may help to visit her during her best time of the day, when she has the most energy and may be less confused.
I know it is difficult and painful to see your mother forget who you are, but keep in mind that the confusion and delusion are caused by a disease. She has suffered too much damage to the parts of her brain that stores those memories and allows her to reason things out. She may have moments of lucidity where she will remember who you are, but these moments are unpredictable.

It is important that you explain the nature of Alzheimer’s disease to your children, so that they do not take it personally when their grandmother confuses them. If you think that your children might need help to understand Alzheimer’s disease, there are actually some good books out there that explain the illness to children.

Keep in mind that even if your mother confuses who you are, you may still be able to provide her comfort and love with your presence.

Dr. Mindy Kim-Miller is a trained medical physician who provides useful, but general answers to questions provided by online visitors. While Dr. Mindy can not provide specific medical advice or services, we hope you find her responses useful in your personal education. All information is provided for informational and educational purposes only and is not meant to be a substitute for professional medical advice, diagnosis or treatment. If you suspect you have an illness or disease, or a health related condition of any kind, seek professional medical care with an appropriate health care professional immediately. Do not postpone or delay seeking treatment or disregard professional advice based upon the general answers provided by Dr. Mindy. Dr. Mindy’s advice is not intended to substitute for a visit to your personal physician or other qualified health provider. Any specific medical concerns or questions you may have should be directed to your personal physician or other qualified health provider.

 

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